Guidewire with tubular connector

ABSTRACT

An improved guidewire for advancing a catheter within a body lumen which has a high strength proximal core section, a flexible distal core section preferably formed of pseudoelastic alloy and a connecting element to provide a torque transmitting coupling between the distal end of the proximal core section and the proximal end of the distal core section. The ends of the core sections are secured within the inner lumen of the connecting element by means of a hardened mass of bonding material. The wall of the connecting element is provided with an opening to facilitate the introduction of the hardenable bonding material in the pourable state into the inner lumen of the connecting element. Preferably at least one of the ends of the core sections are configured, e.g. enlarged in at least one dimension compared to an adjacent part of the core section, to develop a mechanical interlock within the mass of hardened material.

This application is a continuation of U.S. patent application Ser. No.09/382,431, of Mo Jafari, entitled “GUIDEWIRE WITH TUBULAR CONNECTOR,”filed on Aug. 24, 1999, now U.S Pat. No. 6,248,082; which in turn is acontinuation of U.S. patent application Ser. No. 08/948,770, of MoJafari, entitled “GUIDEWIRE WITH TUBULAR CONNECTOR,” filed on Oct. 10,1997, now U.S. Pat. No. 5,980,471; both of which are hereby incorporatedherein by reference in their entirety.

BACKGROUND OF THE INVENTION

This invention relates to the field of medical devices, and moreparticularly to a guidewire for advancing a catheter within a body lumenin a procedure such as percutaneous transluminal coronary angioplasty(PTCA).

Conventional guidewires for angioplasty and other vascular proceduresusually comprise an elongated core member with one or more taperedsections near the distal end thereof and a flexible body such as ahelical coil disposed about the distal portion of the core member. Ashapable member, which may be the distal extremity of the core member ora separate shaping ribbon which is secured to the distal extremity ofthe core member extends through the flexible body and is secured to arounded plug at the distal end of the flexible body. Torquing means areprovided on the proximal end of the core member to rotate, and therebysteer, the guidewire while it is being advanced through a patient'svascular system.

In a typical PTCA procedure a guiding catheter having a preformed distaltip is percutaneously introduced into the cardiovascular system of apatient in a conventional Seldinger technique and advanced therein untilthe distal tip of the guiding catheter is seated in the ostium of adesired coronary artery. A guidewire is positioned within an inner lumenof a dilatation catheter and then both are advanced through the guidingcatheter to the distal end thereof. The guidewire is first advanced outof the distal end of the guiding catheter into the patient's coronaryvasculature until the distal end of the guidewire crosses a lesion to bedilated, then the dilatation catheter having an inflatable balloon onthe distal portion thereof is advanced into the patient's coronaryanatomy over the previously introduced guidewire until the balloon ofthe dilatation catheter is properly positioned across the lesion. Oncein position across the lesion, the balloon is inflated to apredetermined size with radiopaque liquid at relatively high pressures(e.g. greater than 4 atmospheres) to compress the arterioscleroticplaque of the lesion against the inside of the artery wall and tootherwise expand the inner lumen of the artery. The balloon is thendeflated so that blood flow is resumed through the dilated artery andthe dilatation catheter can be removed therefrom.

A major requirement for guidewires is that they have sufficient columnstrength to be pushed through a patient's vascular system or other bodylumen without kinking. However, they must also be flexible enough toavoid damaging the blood vessel or other body lumen through which theyare advanced. Efforts have been made to improve both the strength andflexibility of guidewires to make them more suitable for their intendeduses, but these two properties are for the most part diametricallyopposed to one another in that an increase in one usually involves adecrease in the other.

The prior art makes reference to the use of alloys such as NITINOL(Ni—Ti alloy) which have shape memory and/or superelastic orpseudoelastic characteristics in medical devices which are designed tobe inserted into a patient's body. The shape memory characteristicsallow the devices to be deformed to facilitate their insertion into abody lumen or cavity and then be heated within the body so that thedevice returns to its original shape. Pseudoelastic characteristics onthe other hand generally allow the metal to be deformed and restrainedin the deformed condition to facilitate the insertion of the medicaldevice containing the metal into a patient's body, with such deformationcausing a stress induced phase transformation from austenite tomartensite. Once within the body lumen, the restraint on thepseudoelastic member can be removed, thereby reducing the stress thereinso that the pseudoelastic member can return to its original undeformedshape by the transformation from the thermally unstable martensite phaseback to the original stable austenite phase.

Alloys having shape memory/pseudoelastic characteristics generally haveat least two phases, the martensite phase, which has a relatively lowtensile strength and which is stable at relatively low temperatures,andgan austenite phase, which has a relatively high tensile strength andwhich is stable at temperatures higher than the martensite phase.

Shape memory characteristics are imparted to the alloy by heating themetal at a temperature above which the transformation from themartensite phase to the austenite phase is complete, i.e. a temperatureabove which the austenite phase is stable. The shape of the metal duringthis heat treatment is the shape “remembered”. The heat treated metal iscooled to a temperature at which the martensite phase is stable, causingthe austenite phase to transform to the martensite phase. The metal inthe martensite phase is then plastically deformed, e.g. to facilitatethe entry thereof into a patient's body. Subsequent heating of thedeformed martensite phase to a temperature above the martensite toaustenite transformation temperature causes the deformed martensitephase to transform to the austenite phase and during this phasetransformation the metal reverts back to its original shape.

The prior methods of using the shape memory characteristics of thesealloys in medical devices intended to be placed within a patient's bodypresented operational difficulties. For example, with shape memoryalloys having a stable martensite temperature below body temperature, itwas frequently difficult to maintain the temperature of the medicaldevice containing such an alloy sufficiently below body temperature toprevent the transformation of the martensite phase to the austenitephase when the device was being inserted into a patient's body. Withintravascular devices formed of shape memory alloys havingmartensite-to-austenite transformation temperatures well above bodytemperature, the devices could be introduced into a patient's body withlittle or no problem, but they had to be heated to themartensite-to-austenite transformation temperature which was frequentlyhigh enough to cause tissue damage and very high levels of pain.

When stress is applied to a specimen of a metal such as NITINOLexhibiting pseudoelastic characteristics at a temperature at or abovewhich the transformation of martensite phase to the austenite phase iscomplete, the specimen deforms elastically until it reaches a particularstress level where the alloy then undergoes a stress-induced phasetransformation from the austenite phase to the martensite phase. As thephase transformation proceeds, the alloy undergoes significant increasesin strain but with little or no corresponding increases in stress. Thestrain increases while the stress remains essentially constant until thetransformation of the austenite phase to the martensite phase iscomplete. Thereafter, further increases in stress are necessary to causefurther deformation. The martensitic metal first yields elastically uponthe application of additional stress and then plastically with permanentresidual deformation.

If the load on the specimen is removed before any permanent deformationhas occurred, the martensitic specimen will elastically recover andtransform back to the austenite phase. The reduction in stress firstcauses a decrease in strain. As stress reduction reaches the level atwhich the martensite phase transforms back into the austenite phase, thestress level in the specimen will remain essentially constant (butsubstantially less than the constant stress level at which the austenitetransforms to the martensite) until the transformation back to theaustenite phase is complete, i.e. there is significant recovery instrain with only negligible corresponding stress reduction. After thetransformation back to austenite is complete, further stress reductionresults in elastic strain reduction. This ability to incur significantstrain at relatively constant stress upon the application of a load andto recover from the deformation upon the removal of the load is commonlyreferred to as pseudoelasticity or pseudoelasticity.

The prior art makes reference to the use of metal alloys havingpseudoelastic characteristics in medical devices which are intended tobe inserted or otherwise used within a patient's body. See for example,U.S. Pat. No. 4,665,905 (Jervis) and U.S. Pat. No. 4,925,445 (Sakamotoet al.).

The Sakamoto et al. patent discloses the use of a nickel-titaniumpseudoelastic alloy in an intravascular guidewire which could beprocessed to develop relatively high yield strength levels. However, atthe relatively high yield stress levels which cause theaustenite-to-martensite phase transformation characteristic of thematerial, it did not have a very extensive stress-induced strain rangein which the austenite transforms to martensite at relative constantstress. As a result, frequently as the guidewire was being advancedthrough a patient's tortuous vascular system, it would be stressedbeyond the pseudoelastic region, i.e. develop a permanent set or evenkink which can result in tissue damage. This permanent deformation wouldgenerally require the removal of the guidewire and the replacementthereof with another.

Products of the Jervis patent on the other hand had extensive strainranges, i.e. 2 to 8% strain, but the relatively constant stress level atwhich the austenite transformed to martensite was very low, e.g. 50 ksi.

In U.S. Pat. No. 5,341,818 (Abrams et al.), which has been assigned tothe present assignee, reference is made to a guidewire having astainless steel proximal core section, a flexible distal core sectionformed of superelastic or pseudoelastic nickel-titanium alloy and acylindrical connecting element engaging the distal end of the proximalcore section and the proximal end of the distal core section to providea torque transmission relationship between the proximal and distal coresections of the guidewire. The guidewire described and claimed in U.S.Pat. No. 5,341,818 is sold under the trademark Balance Guidewire by thepresent assignee, Advanced Cardiovascular Systems, Inc. and has met withmuch commercial success. However, notwithstanding the commercial successof this guidewire product, the manufacturing procedures were quitecomplicated due to the requirement of etching and precoating the distalcore section and the cylindrical connecting element, both of which wereformed of NiTi alloy, with a solder material to develop a soundsubsequent soldered bond within the cylindrical connector as describedin the aforesaid Abrams et al. patent.

SUMMARY OF THE INVENTION

The present invention is directed to an improved guidewire having anelongated core member which has an elongated proximal core section and aflexible distal core section, with the distal end of the proximal coresection and the proximal end of the distal core section being securedwithin a cylindrical connecting element in a torque transmittingrelationship. The cylindrical connecting element is provided with anopening in the wall thereof to facilitate the introduction of ahardenable material into the interior of the connecting element whichwhen hardens secures both ends of the core section therein.

Preferably, at least one and preferably both of the ends of the coresections disposed within the interior of the cylindrical connectingelement are provided with means to facilitate interlocking with thehardenable material when it hardens within the connecting element. Inone presently preferred embodiment one or both ends of the core sectionsdisposed within the cylindrical connecting element are enlarged with atleast one transverse dimension greater than transverse dimensions ofportions of the core sections adjacent thereto in order to provide amechanical interlock within the connecting element when the mass ofhardenable bonding material which is disposed about the ends of the coresections hardens within the interior of the connecting element. If thehardenable material naturally bonds to the material of one of the endsof the core sections, there may be no need to provide an enlargeddimension on that end to develop a mechanical interlock when the bondingmaterial hardens. If one of the core sections is a titanium containingalloy such as NiTi alloy, special surface treatments and coatings arenot required as in the procedures.described in U.S. Pat. No. 5,341,818to develop a bond between a solder material and the titanium containingalloy. Other means may be employed to create a mechanical interlockbetween the ends of the guidewire sections within the connectingelement. For example, one or more passages may be provided through oneor more ends of the core sections into which the hardenable material canpenetrate and harden.

The connecting member may be formed of suitable material such asstainless steel, nickel-titanium alloy or even high strength polymericmaterials such as polyimide, polycarbonates, PEEK and the like, so longas there is an effective torque transmitting relationship between theproximal and distal core sections. If the hardenable bonding material isnot bondable to the interior of the cylindrical surface of theconnecting member it may be desirable to provide a protrusion or arecess which will develop a mechanical interlock between the hardenedbonding material and the connecting element to preclude relativemovement therebetween.

Providing an opening within the wall of the connecting element whichprovides access to the interior of the connecting element greatlysimplifies the assembly procedure for the guidewire. The ends of thecore sections are inserted into the interior of the connecting elementthrough the ports in the ends of the member. Hardenable material isintroduced into the interior of the connecting element through theopening in the wall surrounding both ends of the core sections thereinso that upon hardening, the bonding material fixes the core sectionsinto a torque transmitting relationship. The hardenable material can besolder, e.g., solder consisting of essentially 60%-85% by weight goldand the balance essentially tin, an adhesive or other hardenablepolymeric materials.

These and other advantages of the invention will become more apparentfrom the following detailed description thereof when taken inconjunction with the following exemplary drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevational view, partially in section, of a guidewirewhich embodies features of the invention.

FIG. 2 is a schematic perspective view of the connecting element shownin FIG. 1.

FIG. 3 is a longitudinal cross sectional view of the guidewire shown inFIG. 1 taken along the lines 3—3.

FIG. 4 is an elevational view of the guidewire connection shown in FIG.3 taken along the lines 4—4 above the notch in the connecting elementwith the hardened mass of bonding material removed to illustrate thepositioning of the proximal end of the distal core section and thedistal end of the proximal core section.

FIG. 5 is a transverse cross-sectional view of the guidewire connectionshown in FIG. 3 taken along the lines 5—5 with the hardened mass ofbonding material removed for purposes of clarity.

FIG. 6 is a transverse cross-sectional view of the guidewire connectionshown in FIG. 3, taken along the lines 6—6.

FIG. 7 is an elevational view of the distal end of the proximal coresection along the plane of the flattened section.

FIG. 8 is a longitudinal cross sectional view, similar to that shown inFIG. 3, of an alternative guidewire connection with the connectingelement having a inner protrusion to fix the mass of hardened bondingmaterial within the interior of the connecting element.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 illustrates a guidewire 10 embodying features of the inventionthat is adapted adapted to be inserted into a patient's body lumen, suchas an artery or vein. The guidewire 10 comprises an elongated,relatively high strength proximal core section 11, a relatively shortflexible distal core section 12 and a tubular connecting element 13. Thetubular connecting element 13, which is shown in detail in FIG. 2, is ahollow elongated element having an interior or inner lumeri 14 extendingtherein which is adapted to receive the proximal end 15 of the distalcore section 12 into a first port of the tubular connection element andthe distal end 16 of the proximal core section 11 into a second port ofthe tubular connecting element. The connector element 13 generally has acylindrical wall 17 which defines the interior 14 and the wall isprovided with an opening 18 which allows for the introduction ofhardenable bonding material into the interior after the ends of theguidewire core sections are inserted into the interior. As shown moreclearly in FIGS. 3-6, the proximal end 15 of the distal core section 12is enlarged in at least one dimension compared to an adjacent portionof.the distal core section so as to be fixed within the hardened mass ofbonding material 20, disposed within the interior 14 of the connector13. The distal end 16 of the proximal core section 11 is similarly,although optionally, enlarged compared to an adjacent portion of theproximal core section to be likewise fixed within the hardened mass 20of bonding material. The hardened mass of bonding material 20 can besolder consisting essentially of 60-85% by weight gold and the balanceessentially tin, an adhesive or other hardenable polymeric materials.With this connection, the proximal core section 11 is in a torquetransmitting relationship with the distal core section 12.

The connection between the proximal and distal core sections is made byfirst positioning the enlarged proximal end 15 of the distal coresection 12 and the enlarged distal end 16 of the proximal core section11 in close proximity within the inner lumen 14 of the tubularconnecting element 13. Hardenable bonding material in a pourable stateis introduced into the interior 14 of the connector 13 through theopening 18 to surround both ends of the core sections within theinterior. When the bonding material hardens into mass 20 the enlargedends 15 and 16 are fixed within the connecting element to facilitatetorque transmission therebetween. Preferably, enough of the hardenablematerial is introduced so that, when hardened, the notch which forms theopening 18 is filled so as to provide an entirely smooth exteriorsurface to the connecting element 13. If desired, the connecting elementmay be provided with a protrusion 35 m, such as shown in FIG. 8 to fixthe hardened mass 20 within the interior 14 of the connecting element.

The guidewire 10 shown in FIG. 1 generally has conventional features.The distal core portion 12 has at least one tapered section 21 whichbecomes smaller in the distal direction. A helical coil 22 is disposedabout the distal core section 12 and is secured by its distal end to thedistal end of shaping ribbon 23 by a mass of solder which forms roundedplug 24 when it solidifies. The proximal end of the helical coil 22 issecured to the distal core section 12 at a proximal location 25 and atintermediate location 26 by a suitable solder. The proximal end of theshaping ribbon 23 is secured to the distal core portion 12 at the sameintermediate location 26 by the solder. Preferably, the most distalsection 27 of the helical coil 22 is made of radiopaque metal, such asplatinum or platinum-nickel alloys, to facilitate the fluoroscopicobservation thereof while it is disposed within a patient's body. Themost distal section 27 of the coil 22 should be stretched about 10 toabout 30% in length to provide increased flexibility.

The most distal part 28 of the distal core section 12 is flattened intoa rectangular cross-section and is preferably provided with a roundedtip 29, e.g. solder, to prevent the passage of the most distal partthrough the spacing between the stretched distal section 27 of thehelical coil 22.

The exposed portion of the elongated proximal core section 11 should beprovided with a coating 30 of lubricous material such aspolytetrafluoroethylene (sold under the trademark Teflon® by Du Pont, deNemours & Co.) or other suitable lubricous coatings such as otherfluoropolymers, hydrophilic coatings and polysiloxane coatings.

The elongated proximal core section 11 of the guidewire 10 is generallyabout 130 to about 140 cm in length with an outer diameter of about0.006 to 0.018 inch (0.15-0.45 mm) for coronary use. Larger diameterguidewires, e.g. up to 0.035 inch (0.89 mm) or more may be employed inperipheral arteries and other body lumens. The lengths of the smallerdiameter and tapered sections can range from about 1 to about 20 cm,depending upon the stiffness or flexibility desired in the finalproduct. The helical coil 22 may be about 3 to about 45 cm in length,preferably about 5 to about 20 cm, has an outer diameter about the samesize as the outer diameter of the elongated proximal core section 11,and is made from wire about 0.001 to about 0.003 inch (0.025-0.08 mm) indiameter typically about 0.002 inch (0.05 mm). The shaping ribbon 23 andthe flattened distal section 28 of distal core section 12 have generallyrectangularly shaped transverse cross-sections which usually havedimensions of about 0.0005 to about 0.006 inch (0.013-0.152 mm),preferably about 0.001 by 0.003 inch (0.025-0.076 mm).

The distal core section 12 is preferably made of a psuedoelastic alloymaterial consisting essentially of about 30 to about 52% titanium andthe balance nickel and up to 10% of one or more other alloying elements.The other alloying elements may be selected from the group consisting ofiron, cobalt, vanadium, platinum, palladium and copper. The alloy cancontain up to about 10% copper and vanadium and up to 3% of the otheralloying elements. The addition of nickel above the equiatomic amountswith titanium and the other identified alloying elements increase thestress levels at which the stress| induced austenite-to-martensitetransformation occurs and ensures that the temperature at which themartensite phase thermally transforms to the austenite phase is wellbelow human body temperature (37° C.) so that austenite is the onlytemperature stable phase at body temperature. The excess nickel andadditional alloying elements also help to provide an expanded strainrange at very high stresses when the stress induced transformation ofthe austenite phase to the martensite phase occurs.

A presently preferred method for making the pseudoelastic distal coresection is to cold work, preferably by drawing, a rod having acomposition according to the relative proportions described above andthen heat treating the cold worked product while it is under stress toimpart a shape memory thereto. Typical initial transverse dimensions ofthe rod are about 0.045 inch to about 0.25 inch. Before drawing thesolid rod, it is preferably annealed at a temperature of about 5000 toabout 750° C., typically about 650° C., for about 30 minutes in aprotective atmosphere such as argon to relieve essentially all internalstresses. In this manner all of the specimens start the subsequentthermomechanical processing in essentially the same metallurgicalcondition so that products with consistent final properties areobtained. Such treatment also provides the requisite ductility foreffective cold working.

The stressed relieved stock is cold worked by drawing to effect areduction in the cross sectional area thereof of about 30 to about 70%.The metal is drawn through one or more dies of appropriate innerdiameter with a reduction per pass of about 10 to 50%. Other forms ofcold working can be employed such as swaging.

Following cold work, the drawn wire product is heat treated at atemperature between about 350° and about 600° C. for about 0.5 to about60 minutes. Preferably, the drawn wire product is simultaneouslysubjected to a longitudinal stress between about 5% and about 50%,preferably about 10% to about 30% of the tensile strength of thematerial (as measured at room temperature) in order to impart a straight“memory” to the metal and to ensure that any residual stresses thereinare uniform. This memory imparting heat treatment also fixes theaustenite-martensite transformation temperature for the cold workedmetal. By developing a straight “memory” and maintaining uniformresidual stresses in the pseudoelastic material, there is little or notendency for a guidewire made of this material to whip when it istorqued within a patient's blood vessel. The term “whip” refers to thesudden rotation of the distal tip of a guidewire when the proximal endof the guidewire is subjected to torque.

An alternate method for imparting a straight memory to the cold workedmaterial includes mechanically straightening the wire and thensubjecting the straightened wire to a memory imparting heat treatment ata temperature of about 300° to about 450° C., preferably about 330° toabout 400° C. The latter treatment provides substantially improvedtensile properties, but it is not very effective on materials which havebeen cold worked above 55%, particularly above 60%. Materials producedin this manner exhibit stress-induced austenite to martensite phasetransformation at very high levels of stress but the stress during thephase transformation is not nearly as constant as the previouslydiscussed method. Conventional mechanical straightening means can beused such as subjecting the material to sufficient longitudinal stressto straighten it.

Because of the extended strain range under stress-induced phasetransformation which is characteristic of the pseudoelastic materialdescribed herein, a guidewire having a distal portion made at least insubstantial part of such material can be readily advanced throughtortuous arterial passageways. When the distal end of the guidewireengages the wall of a body lumen such as a blood vessel, it willpseudoelastically deform as the austenite transforms to martensite. Uponthe disengagement of the distal end of the guidewire from the vesselwall, the stress is reduced or eliminated from within the pseudoelasticportion of the guidewire and it recovers to its original shape, i.e. theshape “remembered” which is preferably straight. The straight “memory”in conjunction with little or no nonuniform residual longitudinalstresses within the guidewire prevent whipping of the guidewire's distalend when the guidewire is torqued from the proximal end thereof.Moreover, due to the very high level of stress needed to transform theaustenite phase to the martensite phase, there is little chance forpermanent deformation of the guidewire or the guiding member when it isadvanced through a patient's artery.

The present invention provides guidewires which have pseudoelasticcharacteristics to facilitate the advancing thereof in a body lumen. Theguiding members exhibit extensive, recoverable strain resulting fromstress induced phase transformation of austenite to martensite atexceptionally high stress levels which greatly minimizes the risk ofdamage to arteries during the advancement therein.

The connecting element generally may have an outer diameter from about0.006 inch to about 0.02 inch (0.15-0.51 mm) with wall thickness ofabout 0.002 to about 0.006 inch (0.05-0.02 mm). A presently preferredhypotubing from which the connecting element is formed has an outerdiameter of about 0.014 inch (0.36 mm) and a wall thickness of about0.005 inch (0. 13 mm). The overall length of the connector may rangefrom about 0.25 to about 3 cm, typically about 0.75 to about 1.5 cm.

The high strength proximal portion of the guidewire generally issignificantly stronger, i.e. higher ultimate tensile strength, than thepseudoelastic distal portion. Suitable high strength materials include304 stainless steel which is a conventional material in guidewireconstruction. Other high strength materials include nickel-cobalt-molybdenum-chromium alloys such as commercially available MP35Nalloy.

To the extent not otherwise described herein, the materials and methodsof construction and the dimensions of conventional intravascularguidewires may be employed with the guidewire of the present invention.Moreover, features disclosed with one embodiment may be employed withother described embodiments. While the description of the invention isdirected to presently preferred embodiments, various modifications andimprovements can be made to the invention without departing therefrom.

What is claimed is:
 1. An elongated guidewire comprising: an elongatedcore member having a proximal core section with proximal and distal endsand formed from a first material and a distal core section with proximaland distal ends and formed from a second material different than thefirst material, wherein at least one of the distal end of the proximalcore section and the proximal end of the distal core section has atleast one transverse dimension greater than a transverse dimension of aportion of an adjacent section; a connecting element formed at least inpart from a polymeric material and disposed on the distal end of theproximal core section and the proximal end of the distal core sectionand configured to produce a torque transmitting relationship between thedistal end of the proximal core section and the proximal end of thedistal core section; wherein a hardenable material contained within theconnecting element forms a mechanical interlock with the distal end ofthe proximal core section.
 2. The guidewire of claim 1 wherein thehardenable material contained within the connecting element forms a bondwith the proximal end of the distal core section.
 3. The guidewire ofclaim 1 wherein the hardenable material is a polymeric material.
 4. Anelongated guidewire comprising: an elongated core member having aproximal core section with proximal and distal ends and formed from afirst material and a distal core section with proximal and distal endsand formed from a second material different than the first material; aconnecting element formed at least in part from a polymeric material anddisposed on the distal end of the proximal core section and the proximalend of the distal core section and configured to produce a torquetransmitting relationship between the distal end of the proximal coresection and the proximal end of the distal core section, and theconnecting element including a protrusion; wherein a hardenable materialcontained within the connecting element forms a mechanical interlockwith the proximal end of the distal core section and the protrusion ofthe connecting element.
 5. The guidewire of claim 4 wherein thehardenable material contained within the connecting element forms a bondwith the distal end of the proximal core section.
 6. The guidewire ofclaim 4 wherein the hardenable material forms a mechanical interlockwith the connecting element.
 7. The guidewire of claim 4 wherein thesecond material forming the distal core section is a pseudoelasticmaterial.
 8. The guidewire of claim 7 wherein the pseudoelastic materialis a nickel-titanium alloy having a thermally stable austenite phase atbody temperature.
 9. The guidewire of claim 4 wherein the hardenablematerial is a polymeric material.
 10. An elongated guidewire comprising:an elongated core member having a proximal core section with proximaland distal ends and formed from a first material and a distal coresection with proximal and distal ends and formed from a second materialdifferent than the first material; wherein at least one of the distalend of the proximal core section and the proximal end of the distal coresection includes a recess; a connecting element formed at least in partfrom a polymeric material and disposed on the distal end of the proximalcore section and the proximal end of the distal core section andconfigured to produce a torque transmitting relationship between thedistal end of the proximal core section and the proximal end of thedistal core section; wherein a hardenable material contained within theconnecting element forms with the recess for a mechanical interlock withat least one of the distal end of the proximal core section and theproximal end of the distal core section.
 11. The guidewire of claim 10wherein the connecting element is bonded to at least one of the distalend of the proximal core section and the proximal end of the distal coresection.
 12. The guidewire of claim 10 wherein the hardenable materialcontained within the connecting element forms a bond with the other ofthe at least one of the distal end of the proximal core section and theproximal end of the distal core section.
 13. The guidewire of claim 10wherein the hardenable material is a polymeric material.
 14. Theguidewire of claim 10, wherein at least one of the distal end of theproximal core section and the proximal end of the distal core sectionincludes an enlarged end.